I was at a conference last week. At one point the host asked everyone to turn to the person next to them and say what they do. So I told the person beside me about SIPS.
"Pregnancy sickness," they said. "Isn't that really common?"
"Yes," I said. I gave them the numbers. The Royal College of Obstetricians and Gynaecologists says it affects up to 90% of pregnant women.
"Sorry, I don't mean to be rude. But if it's so common, is it really a big deal?"
I have had a version of this question many times, and I think I have realised what lies underneath it. We think common = normal, and normal = fine.
Yes, feeling sick in pregnancy is common. It is something most pregnant women go through, and for many of them the symptoms will be mild. But there is a threshold.
Think about a cold. A cold is common too. Yet we all know there is a point at which it stops being "just a cold". For example, a cough that lasts more than 3 weeks. We don't ignore that point because colds are common.
Unfortunately, with pregnancy sickness, the threshold never made it into the story. Common became normal, and normal became fine, and somewhere in there the point at which a woman needs real help got lost.
Of the women who get pregnancy sickness, around 40% have mild symptoms, 46% moderate and 14% severe. That is 6 in 10 with something more than mild. Worldwide, that is millions of women a year at the severe end.
Whilst it can sometimes be reassuring to hear that something is common, we mustn't lose sight of the threshold, the point at which common stops being normal and a woman needs more help. And if I'm honest, it's not just pregnancy sickness. I think we struggle with that threshold across women's health in general.
Period pain is common. It is not always mild. For some women it means endometriosis, and years of being told it's normal. Hot flushes are common in menopause. For some women they can be manageable. For others they are the reason they stop sleeping, and sometimes the reason they stop working.
We have a habit of filing the common things under normal, and unfortunately the women at the serious end pay for it.
So we must remember that yes, these conditions may be common. But common does not always mean mild.
Sources: RCOG Green-top Guideline No. 69, 2024; Einarson et al., 2013.